Detailed Mechanism Funding and Narrative

Years of mechanism: 2012 2013

Details for Mechanism ID: 14193
Country/Region: Ethiopia
Year: 2013
Main Partner: Abt Associates
Main Partner Program: NA
Organizational Type: Private Contractor
Funding Agency: USAID
Total Funding: $0

The purpose of this wraparound project is to implement Health Sector Finance Reform (HSFR) and develop/implement health insurance programs through the existing health sector management system at the national, regional, zonal/woreda, and health facility levels. Health financing reform is a key priority for the GOE, the PF in goal 3 and throughout the GHI strategy. The program will focus on consolidation of health sector reforms, support to the FMOH to implement national health insurance and generation of evidence to inform policy changes including local retention and utilization of resources through the introduction of user-fees at public health facilities. HSFR will 1) strengthen the capacity of the Federal Planning and Program Department of the MOH, RHBs, woreda health management institutions, hospital and health center management bodies and the new health insurance management institution and 2) establish functioning health center/hospital boards while outsourcing non-clinical services. Coverage includes Oromia, Amhara and SNNPR and expansion is expected to Somali. To help minimize the economic burden of healthcare and unanticipated health costs for individual households, HSFR will pilot, evaluate and scale-up community based health insurance (CBHI), establish a health insurance institution and create a legal instrument for health insurance. A rapid assessment of the current reforms in health care financing including user-fee retention and private sector partnerships such as the establishment of private wings in public hospitals will be conducted. Findings will help increase facilities resource base to increase investment in HR and medical equipment to improve quality service delivery at public health institutions. For scale-up the program will need two new vehicles.

Funding for Health Systems Strengthening (OHSS): $0

The purpose of this award is to implement Health Sector Finance Reform (HSFR), including health insurance programs, at the national, regional, zonal/woreda, and health facility levels to improve access to and delivery of HIV/AIDS and other helath services. The program will address access and efficiency issues by focusing on the consolidation of health sector reforms, supporting the FMOH in the implementation of national health insurance and generating evidence to inform policy changes. COP 12 funds will be used to continue supporting GOE in scaling-up CBHI, provide technical support for the roll-out of the proposed social insurance scheme and wider implementation of HSFR. The program will identify and document challenges as well as the impact of the health care financing on service utilization and service equity. It is expected that the rapid assessment of the program will reveal new opportunities for facility-level health care financing reforms including maximization of outsourcing of non-clinical services and establishment of case-based fees. The program will also continue to provide technical support for GOEs proposed social insurance scheme, including the development of an operational scheme; institutional capacity building; support for the establishment of an institutional mechanism to link insurance administration and accreditation of service providers; and capacity building to create an effective claims process. The program will also work to link national health insurance with satellite activities such as pilot CBHI and other financing programs.

Subpartners Total: $0
Banyan Global: NA
Broad Branch Associates: NA
CARE International: NA
Key Issues Identified in Mechanism
Increase gender equity in HIV prevention, care, treatment and support
End-of-Program Evaluation